摘要
目的:研究下腔静脉塌陷指数(IVC-CI)在预测自主呼吸条件下急性失代偿性心力衰竭(ADHF)容量反应性的应用价值。方法:选择ADHF患者62例,首诊及24h后测量血浆NT-proBNP水平、IVC-CI,按来诊时IVC-CI<0.5(观察组)给予利尿剂治疗和IVC-CI≥0.5(对照组)给予常规治疗进行分组统计。结果:首诊对照组与观察组间差异有统计学意义(P<0.01);24h后对照组与观察组NT-proBNP较治疗前改善,差异有统计学意义(P<0.05);观察组24h后IVC-CI较治疗前改善,差异有统计学意义(P<0.05),对照组24h后IVC-CI较治疗前无明显改善,差异无统计学意义(P>0.05)。结论:(1)IVC-CI可以单独在ADHF中作为容量反应性的一项指标;(2)IVC-CI与NT-proBNP联合检测可以更好的评估ADHF的容量负荷尤其是右心主导的体循环充血;(3)IVC-CI与NT-proBNP联合检测可以更好r指导急诊医师对ADHF的容量管理。
Objective:To study the inferior vena cava collapsibility index(IVC-CI)in predicting acute decompensatory heart failure(ADHF)volumetric reactivity under autonomous respiratory conditions and to guide clinical treatment.Method:Sixty-two patients with decompensated chronic heart failure were selected.The level of IVC-CI and plasma NT-proBNP were measured at the first and second hours.IVC-CI<0.5(observation group)was performed with diuretic therapy and IVC-CI≥0.5(control group)with conventional fluid therapy.Result:There was a statistically significant difference between control group and the observation group(P<0.01)the first-inspection.After 24 hours,the NT-proBNP in the control group and the observation group improved significantly(P<0.05).After 24 hours treatment,IVC-CI was improved in the observation group,the difference was statistically significant(P<0.05).And in the control group,IVC-CI had no significant improvement after 24 htreatment(P>0.05).Conclusion:(1)The inferior vena cava collapse index can be used as an independent indicator of volume reactivity in ADHF.(2)The combined detection of IVC-CI and NT-proBNP can better evaluate the volume load of ADHF,especially the right heart-dominant systemic hyperemia.(3)Combined detection of IVC-CI and NT-proBNP can guide the capacity management of emergency physicians ADHF.
作者
张智玺
韩雪
何春来
王姣
ZHANG Zhixi;HAN Xue;HE Chunlai;WANG Jiao(Department of Emergency,Beijing Jingmei Group General Hospitai,Beijing,102300,China;Beijing Mentougou District Hospital)
出处
《临床急诊杂志》
CAS
2018年第11期754-757,共4页
Journal of Clinical Emergency
